Before the onset of disease, healthy pink gingiva (gum tissue) surrounds the teeth, both holding them in place and preventing infectious material from entering the jaw bone or tooth itself. The tooth includes three regions known as the crown, neck, and root. Gingiva or gum tissue is the soft tissue covering the neck of the tooth. The area between the enamel and the gingiva is called the gingival crevice. The gums are under constant bacterial assault. Gingivitis develops when large masses of bacteria clog the gingival crevice.
Periodontal disease (gum disease) is one of the most prevalent chronic diseases affecting man. Children as young as 5 years of age can have gum disease. By age 35, three out of four people are affected, and by age 65, an estimated 98 percent of Americans have periodontal disease. Periodontal comes from two Greek words that mean "around the tooth." Periodontal disease is caused by certain types of bacteria that form a sticky, colorless film of bacteria that constantly forms on teeth called plaque. Plaque that is not removed can combine with other materials and harden into a rough, porous deposit called calculus (tartar). Calculus on the tooth surface (above the gum line) may not contribute to periodontal disease, but calculus on the neck or root surface (below the gums) makes removal of new plaque and bacteria more difficult. Bacteria in plaque produce metabolic by-products that diffuse into the immediate surrounding area, irritate the gingiva, and result in an inflammatory reaction. The gingiva then swells, become reddened, sensitive to touch and may bleed. It is not normal for gums to bleed when brushing or flossing. Bleeding gums is usually the first sign of gingivitis. Gingivitis is reversible. Gum disease occurs when the gingival crevice between the tooth and gum is more than three millimeters. As gingivitis progresses, the tissue surrounding the teeth is destroyed, the supporting collagen fibers begin to degenerate, and eventually the bone supporting the tooth socket degenerates and results in tooth loss.
Periodontal disease can be prevented by practicing good oral hygiene. Daily tooth brushing and flossing are the most important weapons against the formation of plaque. Brushing your teeth thoroughly at least twice a day helps remove plaque from the outer, inner, and chewing surfaces of the teeth. But careful brushing alone is not sufficient, simply because the bristles of the toothbrush cannot make contact with all parts or sides of the teeth. Dental floss helps to remove plaque from the crevices between the teeth that are often too deep to reach with any sort of brush. Toothpicks are pointed instruments used for removing food or other particles lodged at the base of or from between the teeth. Since manual dexterity decreases with increasing age, the use of toothpicks may be more convenient and require less effort than dental floss. Murtomaa H. Meurman J H, International Dental Journal 1992 Oct. 42(5):365-72.
Toothpicks are usually tapered to a point at one or both ends and are made of wood, plastic, stiff paper, metal, ivory or other materials that provide sufficient rigidity to expel particles between the teeth, yet narrow enough to fit into the interdental spaces. Toothpicks come is various shapes: straight, bent, round, flat, curved, and various combinations. Toothpicks are dispensed singularly, individually wrapped in plastic, in matchbook dispensers, in rolls to be broken off and used, and some are stored in containers. Stuart, U.S. Pat. No. 3,913,596 discloses a ribbon of stiff paper that separates into triangles to dislodge particles between the teeth. Freeman, U.S. Pat. No. 5,704,388 discloses a tubular toothpick formed from synthetic resin materials that has a defined feathered cleaning edge.
Some toothpicks claim the ability to contain different agents. Manciocchi, U.S. Pat. No. 4,509,541 discloses a toothpick attached to a hollow cylinder containing an antiseptic solution to wet the toothpick from a wick. Lichfield, U.S. Pat. No. 4,304,245 discloses a thin sheet of polymeric material rolled to form a tapered tube with a hollow core to remove blood or liquids and may also carry breath fresheners or medicines. Lichfield claims that wooden or plastic toothpicks are only useful for dislodging particles from the teeth, not delivering medications. Howard, U.S. Pat. No. Des. 335,934 discloses an ornamental design for a tobacco-impregnated toothpick. Johnson, U.S. Pat. No. Des. 358,682 discloses an ornamental design for a nicotine containing toothpick. Wiley, U.S. Pat. Nos. 4,846,200 and 5,002,077 discloses a periodontal pocket cleaner, which is a wooden device used to remove material from the periodontal pockets. Wiley differentiates his device from the toothpick and does not claim the toothpick capable of delivering medications.
Besides removing food particles, toothpicks have dental hygiene functions by stimulating gum tissue, removing plaque and calculus that accumulate on the tooth surface and help prevent caries. Toothpicks are usually provided by restaurants and more socially acceptable to use than dental floss.
Using dental floss to help remove plaque from the tooth surface is known in the art. Further, it is known in the art to apply substances and medicaments to dental floss. The substances applied to dental floss can also be applied to toothpicks. As an illustration, therapeutic dental floss has been developed for the following purposes: